Individual
MICHAEL PATRICK MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2200 BRYANT WILLIAMS DRIVE, SUITE 1, KLAMATH FALLS, OR 97601-1121
(541) 884-7746
(541) 884-0848
Mailing address
2200 BRYANT WILLIAMS DRIVE, SUITE 1, KLAMATH FALLS, OR 97601-1121
(541) 884-7746
(541) 884-0848
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP00178
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01237834
RAIL ROAD MEDICARE
OR
Enumeration date
10/07/2005
Last updated
08/31/2016
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